对终末期癌症患者的家庭临终关怀护理的成本效益分析
Ye-Seul Kim1, Euna Han2, Jae-Woo Lee1
1Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Journal of hospice and palliative care
|September 7, 2023
概括
在韩国,对于末期癌症患者来说,家庭临终关怀比住院护理更具成本效益. 即使成本翻了一番,家庭临终关怀仍然负担得起,提供更好的价值和生活质量调整.
科学领域:
- 卫生经济学 卫生经济学
- 息护理研究 息护理研究
- 瘤学结果的结果
背景情况:
- 在韩国,终末期癌症患者的护理存在重大成本考虑因素.
- 评估不同临终关怀模式的经济影响对于资源分配至关重要.
研究的目的:
- 为了比较韩国末期癌症患者住院治疗与在家治疗的宿舍息护理服务的成本效益.
- 根据各种财务情景,确定家庭临终关怀的经济可行性.
主要方法:
- 采用了决策分析的马尔科夫模型,在9周的时间里采用了医疗保健系统的视角.
- 过渡概率来自韩国国家癌症中心和医疗保险审查和评估服务数据 (2017年,2020年).
- 生活质量 (QOL) 被量化为质量调整生命周 (QALW),使用TreeAge软件进行分析.
主要成果:
- 与住院护理相比,基于家庭的临终关怀产生了796,476 KRW/QALW的增量成本效益比率 (ICER).
- 增量成本为697,657韩元,在家庭组的增量有效率为0.88 QALW.
- 敏感性分析表明,如果家庭成本翻倍,ICER可能会增加到1,626,988 KRW/QALW,但如果家庭死亡率翻倍,则会显著下降.
结论:
- 在韩国,家庭临床息护理的成本效益高于韩国末期癌症患者的住院服务.
- 即使相关医疗支出增加了两倍,家庭临终关怀的负担能力仍然保持不变,这表明其可持续性.
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